Customer Care Associate- Medi-Cal
2 weeks ago
We are seeking a highly skilled and customer-focused Customer Care Associate- Medi-Cal to join our team at Niahealthcare. As a key member of our customer service team, you will be responsible for providing exceptional service to our members and providers, ensuring their needs are met and exceeded.
Key Responsibilities- Answer incoming calls related to eligibility, benefits, claims, and authorization of services from members or providers.
- Administer intake documentation into the appropriate systems.
- Provide outstanding service to internal and external customers, striving to resolve member and provider needs on the first call.
- Meet or exceed operations production and quality standards.
- Actively listen and probe callers to determine the purpose of the calls.
- Research and articulate information regarding member eligibility, benefits, EAP services, claim status, and authorization inquiries.
- Resolve customer administrative concerns as the first line of contact.
- Assist in the mentoring and training of new staff.
- Assume full responsibility for self-development and career progression.
- Must be flexible in scheduling and comfortable with change.
- Responsible for meeting call handling requirements and daily telephone standards.
- Must be a proficient typist with strong written and verbal communication skills.
- Must be able to maneuver through various computer platforms.
- Must be able to talk and type simultaneously.
Niahealthcare is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. We offer a competitive salary and benefits package, as well as opportunities for professional growth and development.
-
Care Manager
2 weeks ago
San Diego, California, United States Volunteers of America Southwest Full timeAbout the RoleVolunteers of America Southwest's Enhanced Care Management (ECM) program is seeking a skilled Care Manager to provide whole-person care to Medi-Cal beneficiaries. As a key member of our care team, you will be responsible for assessing the needs of our members, developing personalized care plans, and coordinating services to improve their...
-
Patient Account Representative
3 weeks ago
San Marcos, California, United States Guidehouse Full timeJob Summary:The Insurance Patient Account Representative - Medi-Cal/HMO Emphasis is an extension of Guidehouse's business office staff. This role is responsible for resolving account balances by communicating with patients and insurance companies. The ideal candidate will have experience working with medical claims, appeals, and denials.Key...
-
Investigator
4 days ago
San Diego, California, United States Department of Health Care Services Full timeAbout this Role:The Department of Health Care Services (DHCS) is seeking a skilled Investigator to conduct thorough and complete investigations into allegations of fraud perpetrated against the California Medical Assistance Program (Medi-Cal) and other programs under the department's review.Key Responsibilities:Conduct full and complete investigations into...
-
Social Worker
24 hours ago
San Bernardino, California, United States Regal Medical Group Full timeJob Title: Social Worker - San DiegoWe are seeking a highly skilled Social Worker to join our team at Regal Medical Group in San Diego. As a Social Worker, you will play a critical role in providing exceptional care to our Medi-Cal SPD members.Job Summary:The Social Worker will be responsible for conducting in-depth psychosocial assessments of Medi-Cal SPD...
-
Social Worker
4 days ago
San Bernardino, California, United States Regal Medical Group Full timeJob SummaryWe are seeking a highly skilled and compassionate Social Worker to join our team at Regal Medical Group. As a Medi-Cal SPD Social Worker, you will play a critical role in assisting our members with complex health needs and providing exceptional care coordination services.Key ResponsibilitiesConduct in-depth psychosocial assessments of Medi-Cal SPD...
-
Customer Service Coordinator Lead
2 weeks ago
San Luis Obispo, California, United States CAL POLY Full time{"Job Title": "Lead Customer Service Coordinator", "Job Summary": "As a key member of the Facilities Management and Development (FMD) team at Cal Poly, the Lead Customer Service Coordinator plays a vital role in providing exceptional customer service and administrative support to the campus community. This position is responsible for leading and coordinating...
-
Deputy Medical Director of Managed Care
2 weeks ago
San Francisco, California, United States City and County of San Francisco Full timeJob SummaryThe City and County of San Francisco is seeking a highly qualified Deputy Medical Director of Managed Care to provide leadership and strategic direction in the partnership with the areas of service under the Director of Managed Care. This role will be 10-30% dedicated to clinical responsibilities with the remaining 70-90% dedicated to Deputy...
-
Supervising Psychiatrist
3 days ago
San Francisco, California, United States City and County of San Francisco Full timeJob DescriptionAs a key member of the Behavioral Health Services (BHS) team, the Supervising Psychiatrist will provide clinical leadership and strategic direction in the partnership with the areas of service under the Director of Managed Care. This role will be responsible for supporting increased access to care by facilitating planning and implementation...
-
Property Management Associate
4 weeks ago
San Diego, California, United States Pro Cal Design Inc Full timeProperty Management AssociatePro Cal Design Inc is seeking a meticulous and proactive Property Management Associate to enhance our team. As a vital part of our dynamic real estate development and property management organization, you will contribute significantly to our operations and ensure outstanding service for our clients and tenants.Primary...
-
Customer Service Representative
23 hours ago
San Jose, California, United States Santa Clara County Health Plan Full timeJob SummaryWe are seeking a highly skilled and customer-focused Customer Service Representative I to join our team at Santa Clara County Health Plan. As a key member of our Customer Service Department, you will be responsible for providing exceptional service to our members and providers, ensuring that their needs are met and their concerns are addressed in...
-
Supervisor, Enhanced Care Management
3 days ago
San Diego, California, United States Family Health Centers of San Diego Full timeJob SummaryFamily Health Centers of San Diego (FHCSD) is seeking a highly skilled Supervisor to oversee the day-to-day operations of the Department of Health Care Services (DHCS) California Advancing and Innovating Medi-Cal (CalAIM) specific programs. The successful candidate will have a proven track record of providing exceptional healthcare services to...
-
Custodial Services Associate
3 weeks ago
San Luis Obispo, California, United States CAL POLY Full timeCustodial Services AssociateJob OverviewThis position involves the upkeep and sanitation of designated areas within the facility. Responsibilities include a variety of cleaning tasks such as:Dusting and sanitizing surfacesDisposing of waste and recyclablesCleaning and disinfecting restrooms, including restocking suppliesWashing glass doors, windows, and...
-
Certified Enrollment Specialist
1 week ago
San Jose, California, United States Gardner Family Health Care Full timeAbout the RoleGardner Family Health Care is seeking a highly skilled Certified Enrollment Specialist to join our team. As a key member of our Development, Marketing and Outreach Department, you will play a vital role in helping our community access quality healthcare services.Key ResponsibilitiesScreen patients for Covered California and make follow-up calls...
-
Supervising Care Manager
2 weeks ago
San Diego, California, United States Volunteers of America Southwest Full timeJob SummaryVolunteers of America Southwest is seeking a highly skilled Supervising Care Manager to lead our Enhanced Care Management program. As a key member of our team, you will be responsible for ensuring effective and efficient care management and care coordination throughout the program.Key ResponsibilitiesCarry a caseload of clients and provide direct...
-
RN Case Manager
7 days ago
San Diego, California, United States Serene Health Services Full timeJob SummaryThe RN Case Manager is a key member of our care coordination team, responsible for overseeing the comprehensive care of diverse patient cases. With a focus on chronic conditions, mental health, and homelessness, this role requires effective communication strategies and cultural sensitivity to engage members and providers.Key...
-
Customer Service Supervisor
5 days ago
San Jose, California, United States Santa Clara Family Health Plan Full timeJob SummaryWe are seeking a highly skilled and experienced Customer Service Supervisor to join our team at Santa Clara Family Health Plan. The successful candidate will be responsible for supervising the day-to-day activities of our Customer Service Representatives and Transportation Coordinators, ensuring that our members receive exceptional service and...
-
RN Case Manager
2 days ago
San Diego, California, United States Serene Health Services Full timeEmpowering Lives through Compassionate CareAt Serene Health Services, we are dedicated to delivering exceptional patient care and transforming lives through our comprehensive case management services. As a RN Case Manager, you will play a vital role in overseeing the care coordination for diverse patient cases, utilizing effective communication strategies...
-
Supervising Care Manager
3 weeks ago
San Diego, California, United States Volunteers of America Southwest Full timeJob SummaryVolunteers of America Southwest is seeking a highly skilled and experienced Supervising Care Manager to lead our Enhanced Care Management program. As a key member of our team, you will be responsible for ensuring effective and efficient care management and care coordination throughout the program.Key ResponsibilitiesClient Caseload...
-
Care Management Clinical Social Work Specialist
3 weeks ago
San Diego, California, United States Blue Shield of California Full timeAbout the RoleThe Care Management Clinical Social Work team at Blue Shield of California plays a vital role in addressing the complex social determinants of health for our members. As a Senior Clinical Social Worker, you will be responsible for conducting thorough assessments, developing care plans, and providing intensive interventions to support our...
-
Managed Care Outreach Coordinator
1 week ago
San Francisco, California, United States Pacific Clinics Full timeAbout Pacific ClinicsPacific Clinics is a leading community-based nonprofit provider of behavioral and mental health services and support in California. With a team of over 2,000 employees speaking 22 languages, we are dedicated to offering hope and unlocking the full potential of individuals and families through culturally responsive, trauma-informed,...